I was giving a talk last week to a group that was exclusively female (well, apart from the ‘sound man’). In addition to talking about some general nutritional principles designed to enhance health and energy, I thought I’d talk about some things that tend affect women more than men. Naturally, it occurred to me to talk about pre-menstrual syndrome (PMS). Typical symptoms include fluid retention, breast tenderness and swelling and mood change including irritability and/or low mood. I don’t mean to be glib, but while PMS is often said to affect women only I’m not so sure: many men will have had bad experiences of the quite severe mood issues that can affect some women.
Fortunately, I find in practice that the symptoms of PMS can be considerably improved or even eliminated within 2-3 menstrual cycles through supplementation with the herb Agnus castus. This herb has a long history of use in natural medicine, and has (for what it’s worth) a fair bit of science behind it. For example, a study published in April found that, compared to placebo, Agnus castus improved 16 of 17 PMS symptoms [1].
In practice, I find this herb hugely effective. Very rarely, in my experience, does it fail to bring significant relief. Of course some (or even all) of the benefits may be down to the placebo response. But as I’ve stated before about such things, I don’t care (and neither, generally speaking, do my patients).
My mention of Agnus castus in the presentation last week prompted a lot of scribbling, which made me thing there were many women in the audience who felt they could perhaps do with some. Out of curiosity, I asked women who were using or had used Agnus castus to raise their hands. There were no takers. Some may have been shy about declaring this in public. So, I asked who in the room had even heard of this herb. Again, no takers.
OK, so the women I was talking to were in the banking industry and I suppose should not be expected to be aware of herbal medicines. However, there were about 120 women in the room, and they came from all over Europe, so for no-one to have heard of this herb came as a bit of shock. PMS is a common problem, and for some women can be very debilitating for a few days up to a week or more before their period. Agnus castus offers a cheap, safe and usually effective solution to this issue. Generally, I think more women should know which is why I’m writing about it now.
The last time I wrote about Agnus castus was three years ago. Here’s a link to that piece, which also includes and even older article about the herb and how to use it.
References:
1. Ma L, et al. Evaluating therapeutic effect in symptoms of moderate-to-severe premenstrual syndrome with Vitex agnus castus (BNO 1095) in Chinese women. Aust N Z J Obstet Gynaecol. 2010;50(2):189-93.
Thank you Dr. Briffa
Do you think the doctor should check the prolactin levels first or the symptoms are enough? Would a progesterone cream applied during the luteal phase not be effective?
Hi Dr Briffa,
Agnus Castus is also great for regulating periods that may have gotten a little off-track but should not be used if you are trying to conceive – I found that when I used it, I had mid-monthly bleeding and a pharmacist told me not to use it when I was trying to conceive my daughter, due to the risk to the pregnancy. It certainly helped with getting my periods into a regular groove and I had no problem conceiving at the age of 39.
Is there any suggestion that Agnus castus may also relieve some of the symptoms of menopause?
I have used Agnus Castus to great effect and know of other women who have too – its good to be reminded of this excellent herb!
I wish I could send this to my wife withoug getting an earful for suggesting she suffers from PMS. Perhaps I’ll sign her up for your newsletter if you agree to re-run this in a few weeks?
A word of warning – this herb is very powerful and its effects are not always beneficial. I am a 46-year-old woman with no known health problems. I have been taking Agnus Castus for just over six months after hearing so much about its wonderful female hormone balancing properties. Until I began taking it my periods were always as regular as clockwork, but I have always suffered from PMS (tearfulness, irritability, water retention) for a few days premenstrually, and in the past two years had been getting migraines every month which lasted two or three days. A couple of friends (admittedly with different menstrual problems) had suggested that I try Agnus Castus because of its miraculous balancing effects. I started taking it in tablet form, later switching to the tincture (40 drops per day). Within three weeks I had missed a period (for the first time in my adult life, other than when I was pregnant) and since then my menstrual cycle has been completely unpredictable. Sometimes my period lasts for ten days, sometimes only five, and I never know when it is going to start (or finish). I have put on a great deal of weight, especially around the waist (very unusual for me), despite following a low-carbohydrate diet with zero sugar/refined carbs. I have no energy (I can hardly climb a flight of stairs sometimes) and frequently fall sleep for a couple of hours in the afternoon. I have also become very anxious and depressed, although there is no obvious reason for this. And my migraines are no better, possibly worse.
I have had blood tests (for thyroid, FSH and a number of other things) and a pelvic scan and the results were all negative. As the symptoms came on within three weeks of my starting the Agnus Castus I believe that it is responsible for them, and there is plenty of anecdotal evidence on various forums and websites which shows I am not the only woman who has not been helped by this remedy. (A tip: search for it under its other names, Vitex and Chaste Tree, as well as Agnus Castus.) A couple of herbalists to whom I have just spoken confirm that they have had a minority of patients for whom it has caused such problems.
I am absolutely not disputing that it is an extremely effective and useful herb for the majority of women, just that it should be treated with caution, and never self-prescribed.
I have read that it increases progesterone and wonder if I (and others for whom it makes things worse rather than better) already produce enough progesterone or am sensitive to even small increases in this hormone. Just a thought.
I have stopped taking Agnus Castus and just hope everything returns to normal soon.
An update on my post of 12 November – since I stopped taking Agnus Castus, my periods have returned to normal. The weight I gained around my middle has rapidly disappeared (despite the usual Christmas overeating) and I have much better energy levels. I no longer feel anxious and depressed, and my migraines are much less severe. In short, I feel I am myself again. I am sure that for me (though not, of course, for the many women for whom Agnus Castus has been a blessing), this herb was far from beneficial, and I would advise strongly against self-prescribing.
Agnus castus has a profound effect on the hypothalamus and on pituitary function, helping normalize other hormones and reducing both prolactin and the estrogen-to-progesterone ratio.But one must consult their doctor before taking any medical regimen for safety purposes as this carries side effects if it’s not suited with what your body needs.
hello I seem to have the exact same reaction as Jessica. i have been taking it for a month. how soon after you stopped did you get your period and body back?
i started taking it with goldenseal, and st johns wort and i feel awful!
Are you aware that the European Medicines Agency has rendered Agnus Castus ineffective by capping the dosage to 4mg per tablet (recommended intake for effectiveness as proven in trials is 20mg). I am so angry at this – after nearly having a hysterectomy for painful periods and terrible PMT, I have been symptom free for 5 years since taking 20mg. the Boots Agnus Castus, suggests 2 tablets a day, which means at the level, you would gain no benefit and therefore believe it doesn’t work. My GP can’t prescribe it because it is no in the BNF. I have written blog post all about it with links to research. http://julietocallaghan.wordpress.com/2012/09/11/agnus-castus-a-cure-for-pms-and-why-you-wont-be-able-to-get-hold-of-it-in-boots-an-open-letter-to-the-european-medicines-agency/
On a separate note, the causes of PMT, as far as I am aware are not the same for everyone women and though Agnus Castus is effective for the commonest type of PMT, for some women they have a rarer type (usually associated with the more violent behaviour), that would make black coshosh (I think that is how you spell it) a better treatment.
It would not be an exaggeration to say Agnus Castus changed my life. I was prescribed morphine because my period pains were as awful as labour and lasted 5 days a month (all the morphine did was space me out and make it impossible for me to drive or work). Since taking it, I have not missed one day of work through period pain and no longer dread my periods – often forgetting I am due on.
Ive been taking AC for 6months or more. I take holland and barratt AC 400mg, 2 tabs twice daily. Basically it has been unsuccessful for me. I always had irregular periods but was on combined pill for 10 years and when I stopped it 2years ago my irregular periods came back. I took AC ro regulate my cycle but unfortunately I bleed or stain nearly every day. I have decided to stop taking it today to see what happens. Ive been called to go for a smear but I have not been able to go because of the bleed/stain. If stopping this doesnt help then its a trip to the GP.
I have been taking agnus castus for about a month also 400mg tablets 2 twice a day! And I have noticed myself becoming more and more depressed and anxious and headaches have started. I started taking it because I read it was good for mood swings/anger but it hasn’t done anything so far perhaps I will take the black coshosh as someone else suggests.
I have had the same side-effects from taking AC, as Jessica and others similar. Really low mood, feel exhausted, weight gain, in fact worse symptoms than PMS! I’ve decided to take Vit B6 as prescribed by my doctor and a Magnesium supplement. Also going to cut some things out of my diet.
I have just started taking chaste tree tablets for managing endometriosis and related symptoms (very bad period pains and irregular cycles), its only been for about 4 weeks but i am also experiencing weight gain especially a really bloated stomach and swollen painful breasts. My PMS pain was pretty much the same, slightly less server than normal, and my mood has been slightly better. I’m wondering if maybe you have to take it for a longer period of time for your body to balance out and the good effects to start working. Does anyone know about this?
Also herbal medicines should never be self prescribed, its most likely with self prescribing you will end up with taking too small doses which will have no effect, or doses which are too strong/taken at the wrong times of the day (this usually accounts for most of the adverse side effects). Doctors unfortunately don’t know much about herbal medicines either so its great to get a Naturopath’s supervision when taking these things.
I started taking Agnus Castus about 7 weeks ago. I had read of its miracle effects on PMS – i dont thave physical effects but i do get HOMICIDAL for two weeks a month. so I went on agnus (20mg a day) and back on the combined oral pill. the last period came and went without incident. I feel happier, my skin is clearer, I dont think its just the Agnus – the pill is helping too but by god its not justt he pill either. I feel like a new woman.